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Combined Arterial Hypertension and Ischemic Stroke Exaggerate Anesthesia-Related Hypotension and Cerebral Oxygenation Deficits: A Preclinical Study
CONCLUSIONS: Our findings are the first demonstration that ischemic stroke per se increases the severity of IOH, particularly when combined with a prior history of hypertension; this combination appears to compromise penumbral perfusion.PMID:36730724 | DOI:10.1213/ANE.0000000000006263
Source: Anesthesia and Analgesia - February 2, 2023 Category: Anesthesiology Authors: Tracy Zhang Pratik Thakkar Tonja W Emans Debra Fong Suma Thampi Igor S A Felippe Carolyn J Barrett Robyn Billing Douglas Campbell Fiona D McBryde Source Type: research

Self-Perceived Psychological Stress and Risk of First Stroke in Treated Hypertensive Patients
Objective We aimed to investigate the prospective association between self-perceived psychological stress and first stroke, and to examine possible effect modifiers among adults with hypertension. Methods A total of 20,688 hypertensive adults with information on self-perceived psychological stress at baseline were included from the China Stroke Primary Prevention Trial. Participants were randomly assigned to a double-blind treatment of receiving a single tablet daily with either 10 mg enalapril and 0.8 mg folic acid or 10 mg enalapril alone. Follow-up visits occurred every 3 months after randomization. Psycholog...
Source: Psychosomatic Medicine - February 1, 2022 Category: Psychiatry & Psychology Tags: ORIGINAL ARTICLES Source Type: research

Abstract 232: Parenteral Antihypertensive Use on the First Day of Hospitalization after Acute Ischemic Stroke: A US Population Study Poster Session II
Conclusion: Approximately 16% of AIS patients receive IV AH medication in the first 24 hours of admission in the US. The rate of early AH treatment has increased over time both overall and among those who did not receive rt-PA. Whether this is due to increasingly aggressive BP treatment by physicians or higher BP on admission among AIS patients is unclear. Contrary to recommendations, nicardipine was used infrequently. More evidence is required to justify specific AH agents for BP treatment in AIS.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Wang, Y., McDonough, E., Adeoye, O., LaPensee, K., Crothers, T. C., Kleindorfer, D. Tags: Poster Session II Source Type: research

Folic acid supplementation among adults with hypertension reduces risk of stroke
(The JAMA Network Journals) In a study that included more than 20,000 adults in China with high blood pressure but without a history of stroke or heart attack, the combined use of the hypertension medication enalapril and folic acid, compared with enalapril alone, significantly reduced the risk of first stroke, according to a study appearing in JAMA. The study is being released to coincide with its presentation at the American College of Cardiology Annual Scientific Session.
Source: EurekAlert! - Medicine and Health - March 15, 2015 Category: Global & Universal Source Type: news

Folate Supplements for Stroke Prevention Targeted Trial Trumps the Rest
The effect of folate supplementation on cardiovascular disease has been studied in many observational studies and randomized trials and has been a topic of debate for a number of years. In this issue of JAMA, Huo and colleagues provide results from their important clinical trial of folic acid therapy for primary prevention of stroke. In a carefully designed and executed randomized trial, 20 702 adults with hypertension were randomized to receive enalapril alone (n = 10 354) or enalapril combined with 0.8 mg folic acid (n = 10 348). As recommended by the data and safety monitoring board, the trial was terminat...
Source: JAMA - Journal of the American Medical Association - March 15, 2015 Category: Journals (General) Source Type: research

Cost-effectiveness of folic acid therapy for primary prevention of stroke in patients with hypertension
For hypertensive patients without a history of stroke or myocardial infarction (MI), the China Stroke Primary Prevention Trial (CSPPT) demonstrated that treatment with enalapril-folic acid reduced the risk of ...
Source: BMC Medicine - October 25, 2022 Category: Internal Medicine Authors: Tiantian Zhang, Zhuoru Liang, Tengfei Lin, David J. Cohen, Alejandro Arrieta, Xiaobin Wang, Xianhui Qin, Binyan Wang, Yong Huo, Gordon G. Liu, Jie Jiang and Zugui Zhang Tags: Research article Source Type: research

Drug effects on the cardiovascular system in conscious rats – separating cardiac output into heart rate and stroke volume using PKPD modeling
Conclusions and ImplicationsA systems pharmacology model characterizing the interrelationship between MAP, CO, HR, SV and TPR has been obtained in hypertensive and normotensive rats. The extended model can be used to quantify the dynamic changes in the CVS and elucidate the MoA for novel compounds, with one site of action, using HR and MAP measurements only. The question whether the model can also be applied for compounds with a more complex mechanism of action remains to be established.
Source: British Journal of Pharmacology - June 24, 2014 Category: Drugs & Pharmacology Authors: N. Snelder, B.A. Ploeger, O. Luttringer, D.F. Rigel, F. Fu, M. Beil, D.R. Stanski, M. Danhof Tags: Research Paper Source Type: research

Drug effects on the CVS in conscious rats: separating cardiac output into heart rate and stroke volume using PKPD modelling
Conclusions and ImplicationsA systems pharmacology model characterizing the interrelationship between MAP, CO, HR, SV and TPR was obtained in hypertensive and normotensive rats. This extended model can quantify dynamic changes in the CVS and elucidate the MoA for novel compounds, with one site of action, using only HR and MAP measurements. Whether the model can be applied for compounds with a more complex MoA remains to be established.
Source: British Journal of Pharmacology - September 5, 2014 Category: Drugs & Pharmacology Authors: N Snelder, B A Ploeger, O Luttringer, D F Rigel, F Fu, M Beil, D R Stanski, M Danhof Tags: RESEARCH PAPER Source Type: research

Folate Supplementation in HTN May Lower Risk for First StrokeFolate Supplementation in HTN May Lower Risk for First Stroke
Investigators from China say it's time to rethink the possible CV benefits of folic-acid supplementation: adding it to enalapril reduced risk of first stroke in hypertensive patients without CHD. Heartwire from Medscape
Source: Medscape Cardiology Headlines - March 16, 2015 Category: Cardiology Tags: Cardiology News Source Type: news

In Chinese adults with hypertension, adding folic acid to enalapril reduced incident stroke.
PMID: 26192588 [PubMed - in process]
Source: Annals of Internal Medicine - July 21, 2015 Category: Internal Medicine Authors: Barer D Tags: Ann Intern Med Source Type: research

Folic acid therapy reduces serum uric acid in hypertensive patients: a substudy of the China Stroke Primary Prevention Trial (CSPPT).
CONCLUSIONS: Enalapril-folic acid therapy, compared with enalapril alone, can significantly reduce the magnitude of the increase of UA concentrations in hypertensive adults. This trial was registered at clinicaltrials.gov as NCT00794885. PMID: 28148501 [PubMed - as supplied by publisher]
Source: The American Journal of Clinical Nutrition - January 31, 2017 Category: Nutrition Authors: Qin X, Li Y, He M, Tang G, Yin D, Liang M, Wang B, Nie J, Huo Y, Xu X, Hou FF Tags: Am J Clin Nutr Source Type: research

Homocysteine-lowering interventions for preventing cardiovascular events.
CONCLUSIONS: In this third update of the Cochrane review, there were no differences in effects of homocysteine-lowering interventions in the form of supplements of vitamins B6, B9 or B12 given alone or in combination comparing with placebo on myocardial infarction, death from any cause or adverse events. In terms of stroke, this review found a small difference in effect favouring to homocysteine-lowering interventions in the form of supplements of vitamins B6, B9 or B12 given alone or in combination comparing with placebo.There were uncertain effects of enalapril plus folic acid compared with enalapril on stroke; approxima...
Source: Cochrane Database of Systematic Reviews - August 17, 2017 Category: General Medicine Authors: Martí-Carvajal AJ, Solà I, Lathyris D, Dayer M Tags: Cochrane Database Syst Rev Source Type: research

Perindopril increases the swallowing reflex by inhibiting substance P degradation and tyrosine hydroxylase activation in a rat model of dysphagia.
Abstract Patients with hypertension have a high risk of ischemic stroke and subsequent stroke-associated pneumonia. Stroke-associated pneumonia is most likely to develop in patients with dysphagia. The present study was designed to compare the ameliorative effects of different treatments in rat model of dysphagia. Spontaneously hypertensive rats were treated with bilateral common carotid artery occlusion (BCAO) to induce chronic cerebral hypoperfusion causing disorders of the swallowing reflex. Angiotensin-converting enzyme (ACE) inhibitors (perindopril, imidapril and enalapril), an angiotensin II type 1-receptor ...
Source: European Journal of Pharmacology - November 12, 2014 Category: Drugs & Pharmacology Authors: Ikeda JI, Kojima N, Saeki K, Ishihara M, Takayama M Tags: Eur J Pharmacol Source Type: research

In Context News in brief
Folic acid can reduce risk of first stroke, according to the results of a double-blind trial. 20 702 people with hypertension without a history of stroke or myocardial infarction enrolled in the China Stroke Primary Prevention Trial were randomly assigned to receive either combined enalapril 10 mg and folic acid 0·8 mg or enalapril 10 mg alone. The trial was terminated early, after a median of 4·5 years, when benefits of the combined treatment were identified: there was a significant reduction in risk of first stroke in the folic acid-enalapril group (hazard ratio 0·79, 95% CI 0·68–0·93) compared with enalapril alone group.
Source: Lancet Neurology - April 13, 2015 Category: Neurology Tags: In Context Source Type: research

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